You know, whenever I’m at a meeting or on vacation, I still sometimes feel the tug of the blog. Yet, I tell myself, I need a break. Usually, I handle the problem by setting up several old posts from at least a couple of years a go to repeat, you know, to see how well or badly they’ve aged. Sometimes, however, material is given to me. For example, this e-mail from someone named John who happens to have a .au (Australia) e-mail address:

WHY ARE YOU SO AFRAID…

To put your real name to this Blog—

its probably because you are not a Real person and don’t actually exist–

I have seen Direct evidence of Vaccinations as per Mouldens photos in
children around me, in my family.

Their parents get told by Doctos all sorts of excuses as to why they have
the problems they do—

someone would try and make you believe they were Born ‘WITH A LAZY EYE” but
they weren’t.

Any way if such Vaccinations programmes were so successful around the world
we wouldn’t see the problems we have today. The Medical system has failed
us.

But you know if all your Science was so successful, and based on Truth, then
it wouldn’t need Defending—so

WHY ARE YOU OUT THERE ATTEMPTING TO DEFEND THE TRUTH—THE TRUTH DOESN’T
NEED DEFENDING!

let us others make their own choice——

So have you taken the Swine Flue Shot yet?—based on your ponderings you
would have been the first one lining up for one…..

Comments

Is he trying to tell me my strabismus came about because of vaccination? Because I technically only had “lazy eye” after the surgery. Meanwhile there are lots of picture of little ol’ squinty me born jaundiced and cross-eyed, well before my first vaccine. Oh wait! I’m sorry, anecdotal evidence only counts if it proves vaccines are eeeeeevil. Sorry.

DUMB ASS.
My good friend whose son is special needs, just vented to me about how people have asked her if she had him vaccinated. She looks at them and says, “Yes, he was showing signs before the vaccines anyway, they had nothing to do with it.” She hates the assumptions uneducated people make because once you have a special needs child, you know more about medicine then you ever thought you would. Personally I would like to kick the shit out of people for assuming just a vaccine can cause something instead of their genetics combined with environment, diet, etc.

If they want to obsess over some chemical interaction with the brain, why focus on occasional vaccinations? There’s a daily onslaught of food additives, dyes, plasticizers, and pesticides to which modern children are exposed. Some of them do have known hormonal or neurological effects. To say nothing of heredity, or prenatal and early-childhood development.

Or would that fail to scratch the itch for conspiracy theory? Much more satisfying to imagine that jab is part of the government trying to control you. To make your children autistic for some reason. It’s got to be somebody’s fault, doesn’t it?

Embarrassing that he is Australian, although there are a lot of them here. Even worse, I’ve discovered that a lot of my friends (especially the ones who don’t study science) feel like it’s unclear which side is right. You could call them “agnostics” in regards to vaccines perhaps. This is despite the fact that they’ve all been vaccinated and appear to be relatively intelligent.

In fact the debate reminds me a lot of the “new atheist” debate. They accuse me of being dogmatically in favour of science, and in this case vaccinations and that I am “just as bad” as the people who campaign against vaccinations.

It seems that we now live in a world where the mainstream is unable to evaluate information accurately but judges people on their passion. Ie. people who express the same amount of “zeal” for a cause are just as bad as each other, even when their expressions are at polar ends of the spectrum.

So here’s a guy who chews you out for not using your “real name” for your blog and signs it “John” (from Australia).
Well, THAT narrows it down, doesn’t it?

I ran into this idiocy on another blog when I made a critical comment about an HIV denialist. I attracted a shitstorm of abuse, including several people who traced some of my other postings under my “real name”, reposted them, and then used them for further abuse. Fair comment, I suppose, but every one of these assholes posted anonymously. I refuse to even respond to crap like that.

Any way if such Vaccinations programmes were so successful around the world we wouldn’t see the problems we have today.

I’m very curious about what problems you see and how they relate to the success (or lack thereof) of vaccinations programmes. Perhaps you refer to the annual Polio epidemics that continue to plague Australia or the thousands who die every year from smallpox.

He should thank Orac for witholding his last name. “…names witheld to protect the terminally clueless…”

There are some things that can immediately cue you that the person speaking/writing has not a clue about the subject.

In sports (an area where I have a great weakness), people who use the wrong terms (e.g. saying “…scored a goal…” when discussing baseball) are obviously not familiar with the sport.

In science, there are many cues that the clueless and arrogantly ignorant use to help us identify them. Among the most common is referring to “truth”. Science isn’t about “truth”, it’s about “fact” (or, better yet, data). Science is about finding the rules and mechanisms that control the universe – it’s about finding the ultimate reality.

Reality doesn’t need “defending” any more than the “law” of gravity needs police officers to enforce it.

Likewise, “science” doesn’t need to be defended from the “attacks” of ignorant and uninformed people. It is the ignorant and uninformed who need to be defended from those who would use their ignorance to exploit them. As a biologist, I do not feel “threatened” by creationists (excuse me, “Intelligent Design Advocates”). If it weren’t for their insistence on trying to misinform millions of school children, I wouldn’t pay any attention to them at all.

Orac, like me, is trying to provide information to counter the “forces of ignorance and exploitation”. Andrew Moulder is a perfect example of these “forces”. Whether the result of fraudulent intent, mental illness or simple self-deceipt, Dr. Moulder claims that he can diagnose “micro-infarcts” of the brain by viewing a videotape of the subject. He has provided no data to support these claims.

Dr. Moulder’s claims do not “threaten” science any more than they “threaten” reality. Even if a large number of “scientists” beleived Dr. Moulder’s claims, science would eventually triumph, because even “well-entrenched dogma” has trouble surviving in the face of contradictory data. If nothing else, eventually all the “believers” die off.

The people who are “threatened” by Dr. Moulder’s claims are those people who – because they lack the type of education and training necessary to see through them – are convinced to spend their money and waste their time pursuing his unsupported (and physiologically improbable) “techniques”. It is these people that Orac (and, to a lesser extent, me) is trying to protect by providing them with information to correct their ignorance.

People who feel “threatened” (as “John” does) by information contrary to their beliefs should ask themselves why they feel threatened. A true scientist doesn’t feel threatened by contradicting data – they should take these data and use them to improve their hypothesis.

On the other hand, there is a realm where contradictory data is rejected out of hand and the “messenger” attacked for daring to bring such data. That is the realm of religion.

Most “alternative” medicine practitioners and advocates (and even many consumers) show the unmistakeable signs of religion. They may say (and even think) they are being “scientific”, but it’s just religion dressed up in a lab coat.

I never try to argue a person out of their religious convictions, but I do caution people about the hazards of joining the “faith”.

oh John . .. Dear John.
I’m so so sorry to have to tell you this while you were away, Dear John, but I have to be honest. Dear John, I’m so sorry to tell you that I have met someone else. His name is Science, and, even though he demands evidence and insists on a calm, logical procedure, he means so much more to me than your vague guessing. I’m sorry, Dear John, but your rival Delivers the goods, as they say. I hope that you can understand. Goodbye, John.

Would be nice to be able to blame something other than crappy bad luck and bad genes caused my lazy eye. Maybe then I wouldn’t have had to wear that eyepatch over my good eye for so long as a little kid (who’s bright idea was it to make those adhesive like bandaids?). It did work, sort of, I’m still legally blind in that eye but I do have some use of it.

Since when does the truth not need defending? Do I need to make a list of times that the truth was denied? We still have people denying the holocaust happened, for that matter the fact it happened at all is a case of lies being taken to their ultimate tragic end.

That just made me laugh. His computer needs a vaccination! Odds are, though, that he won’t, because he’s never seen evidence that it’s helpful, then when he gets infected, he’ll infect all his friends’ computers…..

I was still cute as hell though. I bet you were too. Let’s face it, a lot has to go wrong before you get an ugly behbeh [sic].

@Noadi

Did the patch thing, but I used the piratey kind- which was a lot more fun. We alternated eyes daily to avoid one eye going blind. In the end though, it didn’t sort itself out and we had to go the surgical route. I have full use of both, but I can only rarely get the two to work together.

People don’t realize that while it can cause sight issues, a big problem for many is not directly medically related. People take for granted how much first impressions and daily interaction occurs through eye-contact. If you’re focusing on someone with one eye, they get weirded out by what your other eye is doing. Some people are more affected by this than others. I got no end of teasing from people at school, and I’m still self-conscious about it to some extent.

What gets me about our friend John, what really pisses me off, is that now he’s going to insult me the same way his ilk insult autistic people every day. Autistic people get to enjoy labels like “vaccine-damaged”. How insulting. They’re not objects, just because parents expected a cooing and googooing baby, they don’t get to label the child “damaged” because he or she isn’t what they bargained for.

Aww crap. I think I screwed up. My comment dropped the F-bomb, I got confused for a second and thought I was in a more Pharyngulan environment. Can you make like some people do with almond chocolate bars and eat around it? (I.E. “bleep” it.)

Hey, John – I’m a doctor in Australia, and last week I signed the government form requesting a swine flu vaccination.

Like tens of thousands of healthcare staff round the world, I will be having the vaccination as soon as it’s delivered to my hospital.

I am fully vaccinated, and get my yearly flu vaccination as well, to reduce the chance of me infection vulnerable people such as the elderly, babies and those on immunosuppressants.

You, on the other hand, contribute to disease and death around the world with your lies. Did you watch the programme about the baby who died of whooping cough? Did you know that the only measles outbreaks in recent years have been brought by unvaccinated people arriving from outside Australia?

“At one time scientists had to go out and defend the idea that the Earth was round too, thanks to a movement of people willing to lie about the truth and lots of fools to believe them.”

That’s an urban legend, I think. People have known the earth was round for a very long time.

Yes and no, Although educated people have known the Earth was round (and how bit it was) since the ancient Greeks, this knowledge was not common. Christopher Columbus had trouble getting financial backing because most potential investors knew the diameter of the earth was 3 times what Columbus thought it was. The first Prime Minister of South Africa, Paul Kruger, believed the Earth was flat as did many Afrikaners.

That’s an urban legend, I think. People have known the earth was round for a very long time.

Sorry for not being more specific Ender. I wasn’t referring to the story that the the Earth was flat being a widespread belief, but more specifically to the Flat Earth movement in the 1800’s.

Rather than try and convince the scientific community, since they knew they couldn’t, they tried to persuade more of the public that the Earth was flat. The Flat Earth movement back then was a group of religious extremists. The movement was trying to promote the idea that the Earth was flat in order to defend “Christian Morality” in society. They thought that unless the Bible was interpreted literally (including the references that implied the Earth was Flat and circular) that there was no reason to believe any of the Bible, and therefore no basis for any morality at all.

They would invite scientists to join in public debates for which the scientists were usually unprepared for their dishonest tactics. Apparently the Flat Earthers had mastered the “Gish Gallop” even back then. Of course this made the scientific community look bad and the Flat Earth people look “good” to some of the public. They also wrote books,articles, and made public speeches that carefully misrepresented the data to attack the idea of a round Earth.

You can find info on them in the book “Worlds of their Own” by Robert Schadewald.

The current creationist movement seems to be based largely on their tactics and arguments, including the belief that only a literal interpretation of the Bible can promote a sense of morality in society.

He’s actually not a bad guy at all. You know how watching Bill O’Reilly, Stephen Colbert, Glenn Beck and others gives the strong–and correct–impression that they’re playing characters calculated to draw viewership and attention? Orac is somewhat similar. In real life, he’s a nice man, a good doctor and probably a pleasant conversationalist. On this blog, he’s sarcastic, bombastic and more than occasionally insulting to those who disagree with him.

That’s OK. Just don’t take all of this too seriously.

Stop escalating the insults and return to scientific discourse even when you’re dealing with someone who disagrees with you.

“John” does not represent the point of view of those of us reluctant about the current vaccine schedule or the newest of new shots.

By the way, if you believe the hype about Swine Flu, you’re not thinking about this issue very clearly.

“Finally, Orac’s “real” identity is more or less an open secret among some parts of the blogosphere, but he nonetheless keeps using the Orac pseudonym because (1) he doesn’t want his blog to be the first thing that comes up when patients Google his “real” name; (2) he has a long history on the Internet under this particular pseudonym; and (3) he likes the persona that the “Orac” pseudonym allows him to take on. Indeed, even if Orac ever decides to ditch the whole anonymity thing, he will likely retain the pseudonym and simply place a link to his faculty page somewhere on the blog.”

[I]f you believe the hype about Swine Flu, you’re not thinking about this issue very clearly.

No hype belief necessary. The flu has made me miserable whenever I’ve had it. I’ve never had any noticeable ill effects from a flu vaccine, and have never had flu in the years I’ve been vaccinated (though of course some of that was luck in the years they guessed wrong about the seasonal variant).

If my own personal health and comfort weren’t enough motivation, I’m about to visit my nephew at a large university, and I have a 91-year-old father and a mother who’s about to turn 85 whom I visit frequently. I’d rather not be a vector for a disease that could potentially kill my parents at their age.

Therefore I’m getting the seasonal flu vaccine this week, and will get the swine flu vaccine when it’s available to me.

– Far too much blogging to be compatible with a career. Or, indeed, eating and sleeping.
– To few spelling errors/Grammar errors for a Real Human.
– Uses the name ‘Orac’.
– Gets people to claim to know him – clearly evidence of his non-existance.
– I can’t be bothered finding his real name, so it can’t exist.
– We know there’s only one John in Australia. Everyone else is called Bruce – I saw it on TV.
– Case closed.

Well, I am really a Time Lady from the planet Gallifrey, and a member of the Arcalian chapter (hence my assumed surname when I am operating on Earth; why do you all insist on surnames, anyway? what are they for, if you don’t care so much about bloodlines anymore?).

But some minimal searching can probably figure out who I really am too. “Outing” bloggers is very silly. (I did have a laugh when that “before you take that pill” fellow outed Orac, as if he’d discovered some vast secret. Perhaps his google-fu is weak.)

My baby brother had a lazy eye, but with extensive therapy was able to get back nearly full use. He can’t quite point it far enough over, so he wears prismatic glasses. I am *quite* certain that vaccines had nothing to do with it. Snerd’s case, recounted above, is an even better slam-dunk, though, as not only was his case *not* caused by vaccines (as he was born with it), but widespread vaccination could’ve prevented it. (Rubella vaccine doesn’t always “take” so even if his mother was vaccinated, she may not have been protected and would’ve been relying on herd immunity.)

We’ve asked Dr. Gordon to write up case summaries of patients under his care who seemed to demonstrate symptoms of autism shortly after vaccination. Strangely, he’s not done that.

When doctors have important observations that might change how we all practice medicine, they write case summaries and submit them for peer review. Refusal to do so while offering pseudo-scientific arguments in a public forum is not ethical.

The AAP ought to revoke Dr. Gordon’s board certification in pediatrics for such behavior.

(note-posted part of this on the wrong thread before-sorry)
I dont know where you guys live, but over 70% of our county has already had the swine flu. Most of the rest has already been exposed to it. 2 middle schools, 2 highschools and 4 intermediate and primary schools experienced over 400 kids absent at each school every day in the month of Sept. There are only 600-1100 in each school. Of course, the rest of the families all ended up with it too. They are actually still testing people for h1n1 here because most people are paying themselves. Thankfully, no deaths to date. We were waiting for the vaccine, but all 4 of my kids, my husband, me and my mom all already had the virus. Most people will not need the vaccine now, and the school absenteeism has decreased dramatically. I wish they were keeping better track of the outbreaks so they could send the vaccines first to where the most people had not been exposed to it yet.

Had the vaccines been available, most everyone I know would have chosen the vaccine over missing a week of work and/or school with very high fevers, aching bodies, and left with a cough for weeks(still coughing). Actually, by the time each kid in the family went through sickness and then 48hrs of no symptoms before going back to school, most of us missed several weeks of work.

John, I chuckle at your lack of vaccination, both biological and virtual. For your sake, may you get a case of Win32:Virut before you catch H1N1. You won’t get as sick, and at least then you’ll be off the blogs for a while.

Ooh oo0h i just has to jump in without reading other comments! I too have the lazy eye problem but i was religiously restrained from getting any vacinations as a child. Must have been the religion that caused my visual problems!!!

I give vaccines every day. I have told pregnant women that I defer to their discussions with their obstetricians regarding flu shots and that I respect allergists’ recommendations to vaccinate kids with asthma.

The combinations of vaccines we use today are not supported by sufficient safety and efficacy studies.

You keep saying that, Dr. Jay, but you can never give specifics. What specific evidence do you find lacking and what is the scientific basis of your doubt? I’m really getting sick of your repeating the same schtick over and over again without being able to provide a single example or a single cogent criticism of a single study other than that you don’t believe it or you don’t find it adequate. Quite frankly, I don’t care what your opinion with regard to medicine is if you either can’t or won’t back it up with science and evidence.

The Chemist: Your story sounds eerily like mine, except for the order – I did the patch thing (first trying an adhesive patch, but I was allergic to the adhesive, one of my few allergies) on one eye in the middle of eye surgeries for my strabismus. I’ve had four eye muscle surgeries, not all of them on both eyes, the first when I was only three and the last at 11. The third one caused double vision for the year between it and the last one (boy, that was a fun year…), and I was finally able to get both eyes to function simultaneously (most of the time) after surgery #4. (It’s a remarkable thing to finally be able to use a Viewmaster in 5th grade.) I’ve never really heard of any other similar stories before, so your history is very interesting to me.

Ladies and Gentlemen, Orac’s Bill O persona. Bluster, disdain ending with a meaningless rhetorical question unsupported by either facts or the preceding statements

One more time, you do not have safety and efficacy studies for combining vaccines the way we do now!! You would not give your own child the “cocktail” of six vaccines with 10-15 components at the same time. Informal surveys of pediatricians have shown that we agree and do not give our own kids all the shots at the same time.

It’s not my job to show that the combined vaccines are dangerous, it’s yours/theirs to show that they’re safe!!! Don’t point at the few scattered studies funded by the manufacturers, show me comprehensive data showing long term safety and efficacy of combining vaccines as we are told to do.

In reply to my “if you disagree with ‘John,’ we sure can’t tell from your public disagreements with him” observation, Dr. Jay replies:

I give vaccines every day. I have told pregnant women that I defer to their discussions with their obstetricians regarding flu shots and that I respect allergists’ recommendations to vaccinate kids with asthma.

You really should get a medal for allowing those parents to bully you into “reluctantly” [1] vaccinating their kids.

The combinations of vaccines we use today are not supported by sufficient safety and efficacy studies.

Hi guys unfortunately i come from a land down under like john. And the johns of the world put so many people at risk. Can I ask Orac and others here one vaccine question (YES I AM A SUPPORTER). I have a 16 year old daughter with fairly serious chronic asthma, the swine flu vaccine has become available but she has always had a cold or asthma when I’ve tried to arrange it. Should i go ahead in this situation or wait for a window of “health”?

PS Is it possible to self adminster (i undertsand it is single use Im injection) or does it need to be administered by the GP or nurse?

Ladies and Gentlemen, [scientist]’s Bill O persona. Bluster, disdain ending with a meaningless rhetorical question unsupported by either facts or the preceding statements

One more time, you do not have safety and efficacy studies for combining [foods] the way we do now!! You would not give your own child the “cocktail” of six [food groups] with 10-15 [nutrients] at the same time. Informal surveys of [nutritionists] have shown that we agree and do not give our own kids all the shots at the same time.

It’s not my job to show that the combined [foods] are dangerous, it’s yours/theirs to show that they’re safe!!! Don’t point at the few scattered studies funded by the manufacturers, show me comprehensive data showing long term safety and efficacy of combining [foods] as we are told to do.

If my child falls over outside and scrapes their knee, then they must be exposing themselves to hundreds of different strains of live bacteria! You have to wonder how the human race has survived if exposure to just 15 antigens causes damage.

Indeed, and breathing, touching household items or other people, etc., expose us to hundreds or thousands more. Of course there is a difference between skinning knees and breathing on the one hand, and vaccines on the other – the bacteria or viruses in the environment are capable of causing disease in humans, whereas the killed, weakened, or otherwise disabled varieties in vaccines are not.

Vaccines mimic the natural process of “teaching” the immune system to respond to an antigen, but without the, ehm, inconvenience of getting deathly ill in order to achieve that.

yoyo: I could be wrong (I Am Not A Doctor), but my understanding is that having asthma is not a contraindication for getting the shot, but having a cold is — not necessarily that it would keep the shot from working, but there is a definite preference that you (or your daughter, natch) wait until the cold is gone or at least until there isn’t a fever any more.

I don’t think the shot is self-administered. I believe there is a preference that it be done in a controlled setting in case there IS a reaction.

One more time, you do not have safety and efficacy studies for combining vaccines the way we do now!! You would not give your own child the “cocktail” of six vaccines with 10-15 components at the same time. Informal surveys of pediatricians have shown that we agree and do not give our own kids all the shots at the same time.

Are you sure of this, Dr. Jay? I thought that each addition to the vaccine schedule was tested versus the previously existing vaccine schedule. I can’t even think of any other ethical way to do a vaccine trial, since you cannot reasonably deny people vaccinations that have previously been shown to be safe and effective in protecting against disease. Can you provide citations or other evidence that this was not done?

Rationally, I can think of many reasons why risks could be multiplied by multiple injections, aside from the additional expense of multiple doctor visits (although that is a benefit to you isn’t it?), not to mention the discomfort of multiple injections, which is certainly significant to children. So what safety and efficacy studies can you cite to show that giving multiple injections is as safe as following the standard protocol, which has been subjected to standard safety testing in development, as well as extensive post-marketing surveillance? (Although I’m probably wasting my time in asking, since your standard answer to such questions seems to be along the lines of, “I don’t need no stinkin’ evidence–I’m a doctor and I can divine the truth intuitively due to my vast clinical experience”).

@45 This bothers me, but Dr Jay’s experience is the same as what I have seen in regards to pediatricians vaccinating their own children. My children are older, and this was not a common discussion among pediatrician parents 10 years ago. However, I can tell you without a doubt that it is a hot topic now, although usually private . I specialize in neurodevelopmental disabilities, and as such, have conversations with pediatricians daily. I also travel in the states and abroad as part of an IHS (international health spec) team. I meet pediatricians from all over the world expressing the same comments as Dr Jay. Most of them do not speak of it publicly. They admit privately that they do not follow the current vaccine schedule as far as timing, some dont give all the vaccines, and some none at all to their own children. They all, categorically agree, that “vaccine studies to date dont exist to show safety when vaccines are given in multiples and dont take into account the things infants are exposed to in our world today”. The most common thing I hear is that they are still keeping the herd immunity intact by vaccinating, and… delaying doesnt hurt anyone, but it could possibly lessen the burden placed on a developing child’s immune system. Dr Jay ‘speaks out’, but he is far from alone.

@40 county, not country. red zone area(widespread) in Fl for h1n1 for about 5 weeks. It is decreasing now according to the health dept.

@52 I know that was meant to be funny, but you actually can poison your kids faster with some foods than you could with a vaccine. Nothing tastes better than homegrown and home cooked. That is why I married an amazing retired chef turned farmer! amongst other reasons

It’s typical that Dr. Jay would embrace anecdotes about how many pediatricians supposedly don’t follow recommended vaccination schedules for their children. After all, his own antivax prejudices are based on anecdote and personal bias rather than solid evidence-based research.

We have better evidence than supposition and rumor when it comes to pediatricians’ immunization practices affecting their own kids. Multiple surveys have shown that better than 90% of pediatricians follow the official guidelines promulgated by groups such as the American Association of Pediatrics (the same organization that Dr. Jay never tires of boasting his affiliation with, even as he embarrasses it through his wilful ignorance). Surveys in other countries demonstrate similar findings, as with this one in Switzerland:

92% of pediatricians in that sample reported following the guidelines for their own kids.

And even in cases like the varicella vaccine (where there was some initial controversy in the medical community over adding vaccine protection), roughly the same percentage of pediatricians practiced what they preached in regard to their own children:

Sorry, Dr. Jay – you’re still very much an outlier when it comes to vaccination. Most pediatricians base their practices on solid science, and value it when it comes to their kids as well.

Waiting…”Why don’t you actually answer trrl’s questions Dr. Jay?”

Dr. Jay doesn’t answer questions that might actually require him to be responsive, or to think. He’s here to snipe at critics and to get attention. Lately he’s taken to random appearances in threads like this one, where some other antivirus wacko’s ravings are being debunked. Dr. Jay resents being out of the spotlight.

Dr. Jay keeps telling us that he’s learned ever so much by participating in discussions on this blog. But he keeps repeating the same antivax tripe. To repeat a question you failed to answer in an earlier post, what exactly is it you’ve learned about vaccination, Dr. Jay, and are you actually applying this newfound knowledge in practice to the benefit of your patients?

Dr. Jay: “I have to get a grade of “100%” every day in my office or I could hurt children.”

Prometheus, as usual, gets it right. The weasel word that Dr. Jay is using is “sufficient,” which he can define any way he wants in order to dismiss studies. So, I join Prometheus in requesting that Dr. Jay define exactly what he means by “sufficient.” Then we can look at the scientific evidence and see whether it is or is not “sufficient” by Dr. Jay’s definition.

Of course, I suspect that the evidence supporting Dr. Jay’s and Dr. Bob’s practices will be considerably less than “sufficient” by any definition and less “sufficient” even by Dr. Jay’s definition, but that’s what you get when you argue belief rather than science.

Because his questions are either inane or rhetorical and need no answer: There are no sufficient studies supporting either “my” side of this discussion or the other side.

So your argument is that neither is “adequate” by your standards, so that one is just as good as the other? Even though the standard schedule has been given to a huge number of people and subjected to extensive post-marketing surveillance, while you just pulled yours out of your…er…clinical experience?

And you still haven’t answered my other request, for a citation supporting your claim that there has been no testing of the combination schedule. Surely you wouldn’t make such a claim without evidence–or did you get it from the same place where you got the idea that traces of formaldehyde in vaccinations were likely to be dangerous? Please provide evidence that new additions to the vaccination schedule are not tested for safety and efficacy against the previous schedule, or else retract the claim.

Although this results in a double-negative (“…not supported by no safety…”), I suspect that “Dr. Jay” is trying to say that no safety and efficacy studies have been done on the current vaccination schedule. Unfortunately (for “Dr. Jay”, that is simply not true, so he can’t weasel out that easily.

Each vaccine, as it was approved, was tested in combination with all previously approved and recommended vaccines. That means that the latest approved vaccine (rotavirus, in the US, I believe) was tested in combination with all previously approved and recommended childhood vaccines.

So, now that your assertion has been shown to be false, how do you intend to proceed, “Dr. Jay”?

Answering the question might be a good start. Let me restate it, so you don’t have to strain your web browser.

What, in your opinion, “Dr. Jay”, would be “sufficient safety and efficacy studies”?

[NOTE: I expect that “Dr. Jay” will next lash out in a fit of pique, accusing all present of being “rude”, “uncivil” and “argumentative” or other such nonsense. I seriously doubt that he will even attempt to answer the question, for reasons I have already stated.]

Bacon @65 Those surveys were done 5-7 years ago. I am afraid vaccines are not looked upon in the same light anymore. Not to mention, pediatricians have told me to my face that they dont vaccinate their own children with the same schedule, but that they would never admit that on the record. They do not want ‘any problems’. Cant say I blame them. I dont give my own dogs the same vaccines I give other people’s pets. I only vaccinate them on that schedule because the AVMA recommends it. Anyway, I thought this blog was about something else, but I see it is about some Jay person.

What I meant was that are no studies supporting the safety of vaccinating as we do. None. Fragmented publications of one combination or another but no studies which show that it’s safe to give that many vaccines to a six-week-old baby.

And, yes, my understanding of how pediatricians vaccinate their own children–and their close friends’ children–is anecdotally based. But, the “official” surveys suffer from flaws big enough to give even you pause, Bacon.

Bacon, your irony meter should be set to stun instead of kill, obviously. It would malfunction far less often.

What have I learned, Bacon? I’ve learned that absolute statements about vaccination are not intelligent nor viable parts of any argument. Vaccines are neither absolutely good nor bad and should be given, not by rote, but using judgement and experience. For those of you with neither, use the book.

Chris, it’s not “anti-vax garbage.” It’s a valuable contribution to the discussion from a health care practitioner who gives vaccines, believes they are useful and safe but is not comfortable with the current schedule.

The recommended schedule is based on expediency and economics and not on science.

You have four docs in here all telling you the same thing: Pediatricians do not vaccinate their own children the way the AAP and CDC recommend. When will you stop trying to give semi-clever nasty answers and listen instead?

Clearly pediatricians are just as vulnerable to the madness of crowds as any other collection of human beings. I woundn’t put much confidence in the personal opinions of pediatricians too fearful to speak openly about the reasons for their vaccination worries.

We invented science so we wouldn’t have to rely upon whispers and rumors.

The plural of anecdote is not data, especially when it is just four pediatricians. Especially if one that is completely clueless and actively panders towards the anti-vax crowd (so whose book did you write that forward for… was it for a someone who actually had academic credentials in immunology and medicine, or was it some B-list actress?).

Please, for your daughter’s sake, do not solicit medical advice from complete strangers on an internet blog. If you have questions, the person to ask is your family physician. No responsible medical professional would or should give specific advice without a comprehensive evaluation of the individual in question.

The plural of anecdote is not data, especially when it is just four pediatricians.

Indeed not. And it isn’t *even* four pediatricians. Aside from Dr. Jay, I count one commenter at #59 who ‘specializes in neurodevelopmental disabilities’ (maybe an M.D., but other occupations could also legitimately claim this specialty) who in the course of his/her work has spoken to pediatricians. Then there’s B. Cohnstein @74–perhaps a veterinarian, definitely not an MD of any kind, who reports conversing with pediatricians at some point. Am I missing someone?

Anecdotal evidence is weak no matter how you slice it, but it gets weaker still if the anecdotes in question are 2nd or 3rd hand.

Bacon, your irony meter should be set to stun instead of kill, obviously. It would malfunction far less often.

No Dr Jay those are phasers, irony meters do not have stun or kill settings as they are passive sensors. Although they may cause serious injury if used on your comments without taking proper precautions, and Bacon really should know better by now.

Re my: #83–I stand corrected. EJB has previously identified him/herself as a pediatrician in a comment thread from over a month ago. S/he appears to share Dr. Jay’s ‘safety concerns’ about the current vaccine schedule.

Interestingly, s/he only showed up in the other thread after Dr. Jay had been here going at it for a while. More interesting is the fact that Dr. Jay counted him/her as one of the ‘four’ docs in his corner on this thread, despite the fact that EJB did not identify him/herself as such. I suspect Dr. Jay is attempting to bolster his credibility by calling in friends to back up his fact-free claims.

This is a personal web log, reflecting the sometimes prickly opinions of its author. Statements on this blog do not represent the opinions of anyone other than the author. They most definitely do not represent the opinions or position of the author’s hospital, university, cancer institute, surgical practice, partners, or research colleagues. The information on this blog is intended for discussion and entertainment purposes only and not as recommendations about how to diagnose or treat illnesses. Any personal medical issues the reader may have should be referred to the reader’s physician. If the reader freely chooses to follow the opinion of a pseudonymous blogger like the author (who has also not done a proper history or physical examination and whose credentials cannot be verified) over that of his or her own personal physician, it is the reader’s decision alone, for which the reader must bear full responsibility.

B.Cohnstein says: “Bacon @65 Those surveys were done 5-7 years ago. I am afraid vaccines are not looked upon in the same light anymore. Not to mention, pediatricians have told me to my face that they dont vaccinate their own children with the same schedule, but that they would never admit that on the record.”

Antivax nonsense (including the alleged vaccine-autism link) was already widespread at the time those surveys of pediatricians were done. Sometimes we forget that these attitudes have been circulating in one form or another since the 19th century. The cited surveys (anonymous for participants) are published evidence that the vast majority of pediatricians do not fall for the same misconceptions as do Dr. Jay and Dr. Bob Sears, no matter what the docs who whisper to you at cocktail parties are allegedly saying.

As embarassing as the few pediatrician spokesmen for antivax ignorance are to the rest of the medical profession, it’s good to know that intelligent and sane voices remain. For example, here’s a pediatrician who’s interested in recommending the best available medicine to his patients:

“We feel confident in the safety of our vaccines. We recognize there are known possible side effects from some of the vaccines and it is important to discuss these. However, the benefits of vaccinations far outweigh their risks. This is overwhelmingly supported by extensive research. We firmly believe, based on available medical literature and evidence, that vaccines do not cause autism or other developmental disabilities.

The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that some are even discussing whether or not they should be given. Because of vaccines, many of you have never seen anyone with polio, tetanus, hepatitis, whooping cough, bacterial meningitis or measles. Such success can make us complacent about vaccinating and allows some to focus on the risks rather than the benefits. However, as a group of providers, we have unfortunately seen significant adverse outcomes from these illnesses.

Some parents have approached me with “alternative” vaccine schedules that claim to reduce various risks by “stretching out” the course of the vaccination process. This unfortunately increases the length of time the child is exposed to serious infections.”

Dr. Jay’s comments make clear that in fact he has learned nothing in his time here. The only good thing is, that represents time not spent misleading the families of his patients and contributing to flawed judgment that endangers children.

Bacon says:“Dr. Jay’s comments make clear that in fact he has learned nothing in his time here. The only good thing is, that represents time not spent misleading the families of his patients and contributing to flawed judgment that endangers children.”

Bacon, please notice that most of my posts are late at night and I rarely take time off from misleading and malpracticing during the day.

The pediatrician you cite above is just one voice among many. I practice using experience and knowledge gained from excellent training, continuing medical education and lots of reading. Guess who writes the articles “debunking” Bob Sears? The $29,000,000 man.

I have not walked in your shoes–and you post no biographical or personal information–so I know nothing about your profession. You, my long time acquaintance, know nothing about mine.

Dr. Jay (who evidently prefers not to read articles by knowledgeable sources whose conclusions he doesn’t like), is referring to the co-author of the pediatrics journal paper on “alternate” vaccine schedules, Paul Offit M.D. For those who don’t know, Offit is chief of the infectious diseases division at Children’s Hospital of Philadelphia and author of “Autism’s False Prophets”. Dr. Jay, as a low-level acolyte and enabler of the antivax movement (not yet a prophet, though he aspires to be), prefers to attack Dr. Offit by insinuation rather than deal with the points he raises.

If we contrast the training, experience and achievements of a man like Paul Offit (who has also developed a lifesaving rotavirus vaccine) with those of Dr. Jay – well, let’s just leave it as demonstrating a rather marked contrast.

I said it bothers me that Dr Gordon is far from alone in his convictions. I would have to agree that a survey 5-7 yrs ago would no longer be accurate. Even though there were anti vax movements prior to that survey, the number of pediatricians confronting me about the schedule has increased tremendously the past 2-3 years. I pointed out the trend because it is alarming.

You cant use that post to bolster your objective. Definitely not a friend in that corner.

EJB, are you going to get a good counting of those pediatricians, just like the numbers of children you say changed after their vaccines… but then didn’t in the numbers you implied (because you weren’t taking the data)?

Bring on the evidence. Stop giving us anecdotes and opinions. Do a survey, go over the records… then write the paper and get it published.

What I meant was that are no studies supporting the safety of vaccinating as we do. None. Fragmented publications of one combination or another but no studies which show that it’s safe to give that many vaccines to a six-week-old baby.

So you dismiss all of the controlled studies that were carried out with each successive addition to the vaccine schedule, as well as the extensive postmarketing surveillance based upon millions of doses of vaccine? Can you really say that is no evidence?

On the other hand, what evidence is there for the safety of the various “alternative” vaccination schedules? What evidence is there that these modified schedules have any benefits other than more office visits and more money for pediatricians? Here, the answer really is, “None.”

But of course Dr. Jay doesn’t need any stinking evidence to justify subjecting children to an untested vaccine schedule. He has “judgement and experience.” Presumably, the same judgement that led him to conclude that formaldehyde in vaccines poses a danger to children…

trrll–Your browser is stuck. You keep repeating the same post. Try a restart holding down the “option” key and the “wit” key at the same time.

EJB, I ask for no friendship; Merely mentioning your acknowledgement that we, and other peds, know that there are a lot of us shying away from the recommended vaccine schedule. You need not be one of those docs. (But I’m guessing you might be.)

There is no evidence that an alternative vaccine schedule is safe. That’s easy. No proof of safety, no expectation of real studies. Therefore, in the absence of real science, use caution and trust experience.

Jay, are you feeling well? “Trust experience”? Are you finally advocating for the scientific method? After all, what is science if not a means to determine which experiences are objective and real, and thus worth trusting? I trust you’ll be vaccinating all the kiddos that enter your office, and will denounce your antivax former buddies as the deadly charlatans they are.

“I would have to agree that a survey 5-7 yrs ago would no longer be accurate.”

True, a lot has happened since then.

Many new studies have emerged that debunk an autism-vaccine link. We’ve had time to see that the thimerosal preservative removed from virtually all vaccines in 2001 did not cause autism, both through the autism rate being stable or increasing since then, and through good scientific studies as well. And perhaps most devastating to the antivaxers, a federal vaccine court ruled against an autism-vaccine connection.

So with all that persuasive evidence and logic indicating the safety of vaccines (not to mention the re-emergence of infectious diseases once thought conquered through diminished vaccination rates, plus the specter of H1N1), it could well be that an even more overwhelming majority of pediatricians now support vaccine recommendations and follow them for their kids.
But we’ll need better evidence to support such a statement. Supposition and anecdotes aren’t enough.

My guess is that the true answer is that the only “sufficent safety and efficacy studies” to Dr. Jay would be at least one study beyond what we already have and that his answer will always be so. He passionately believes that vaccines cause autism and, like all good anti-vaccine apologists, knows the art of shifting the goalposts. Of course, he also knows that it’s better not to provide any goalposts to shift in the first place if he can avoid it. If he makes the location of his goalpost as vague as possible, then no one can accuse him of shifting it. Fuzziness is Dr. Jay’s friend, both in feelings, logic, and science.

“I am afraid vaccines are not looked upon in the same light anymore. Not to mention, pediatricians have told me to my face that they dont vaccinate their own children with the same schedule, but that they would never admit that on the record”.

Those ped’s are actually the worst of the worst… It’s one thing to be completely stupid/ignorant about the dangers of vaccinations… it’s an entirely other thing to know that vaccines can/do hurt babies and then push them on unsuspecting moms and dads who aren’t as knowledgeable about the dangers. Those are the real criminals in the biz.

Mind you, I believe vaccines are safe. However, if I thought they were dangerous but pretended otherwise and continued to use them on kids… well, it’s hard to imagine how this would work inside my head.

I’d need to borrow some of Dr. Gordon’s obfuscating wool to dampen the cognitive dissonance. Maybe I’d pretend that a scientific consensus is no different from a political consensus or a matter of personal taste. De gustibus non est disputandum!

Hopefully my colleagues wouldn’t notice that I actually do respect the scientific consensus when treating asthma or leukemia or other pediatric conditions.

The more I read, the more angry I find myself. Since Dr. Jay values anecdotal data so fricking much, here’s my anecdote.

I work in a clinic with 8 clinicians. We ALL vaccinate per the recommended schedule. All of us. Including our kids. The only concession that we’ve made to the schedule (which tends to depend on what vaccines we have) is to not give more than 4-5 injections at the same time. Why? Because 4-5 injections all at once hurts. My clinic is part of four other family medicine clinics which encompass at least 30 clinicians (not including our 36 residents). We all vaccinate per the recommended schedule.

My son, who is singularly more precious to me than anyone else in the world (apologies to my husband), is turning one years-old this week. I have a history of autism in my family. Over the next 3-6 months, he will receive the following vaccines: Dtap, Prevnar, Hib, Hep A #1 & 2, seasonal influenza #1 & 2, H1N1 influenza #1 & 2, MMR, and varicella. That’s 11 shots. I can decrease his vaccine shot number by one if I give him an extra IPV (by using Pentacel). If the MMRV is available through his physician, I will use that as well. That’s still about 9 shots in the next 6 months. I won’t allow more than 4 shots at a time, but he is going to get all of his shots (and when I get back to clinic, I’m getting the H1N1). By the time he is 18 months-old, he will be completely on schedule. I do this for my son and I do this for my patients. To do otherwise is to practice poor medicine.

Oh and Dr. Jay? Where’s your evidence that your delayed schedule is any safer or better than the recommended one? Hmmm? Yeah, I thought so. Given the choice, I’m going with the CDC rather than you or Dr. Sears.

gaiainc “Over the next 3-6 months, he will receive the following vaccines: Dtap, Prevnar, Hib, Hep A #1 & 2, seasonal influenza #1 & 2, H1N1 influenza #1 & 2, MMR, and varicella. That’s 11 shots. I can decrease his vaccine shot number by one if I give him an extra IPV (by using Pentacel). If the MMRV is available through his physician, I will use that as well. That’s still about 9 shots in the next 6 months. I won’t allow more than 4 shots at a time, but he is going to get all of his shots (and when I get back to clinic, I’m getting the H1N1). By the time he is 18 months”

In other words, you are another doctor that chooses to muck around with the schedule for your own kid but not fight it as a whole! Why dont you fight to make that the standard for all! That is technically a schedule change too. That is all I hear others ask for. My nephew just got 7 shots in one day! His mom was told he “Needed Them”. What a bunch of horseshit. Just because pediatricians do for other patients what the stupid board tells them too, does not mean they are doing it exactly that way for their own kid! They arent being criminal, they are doing what they are told.

meson, there’s an important difference between what Dr. Jay is saying and what gaiainc said.

Doctors frequently adapt published clinical guidelines to address the unique circumstances of individual patients. Fighting the guidelines “as a whole” would merely create new guidelines. But those new guidelines would also need to be modified in certain cases due to other concerns.

Dr. Sears argues that the CDC schedule is “too many too soon.” He published an alternative schedule in his book. However, he hasn’t done the hard work necessary to justify his recommended changes.

We know that Dr. Sears’ schedule will increase the risk of illness among children due to vaccine-preventable disease. We don’t know if it will reduce the risk of adverse vaccine reactions. In other words: Dr. Sears is a maroon.

My son is on the CDC schedule, and in the first three rounds, has never had more than 2 shots in a single day.

And gaiainc isn’t doing anything about “changing the schedule.” If you read what she wrote, she included all the flu shots in among the immunizations. There is nothing wrong with rescheduling them (or any, for that matter) by a week or two to allow time for injection site pain to subside.

Oh my!!!!! She did her third round of shots at 6 months and 2 weeks!!!! She’s changing the schedule!!!!!!

titmouse, agreed, doctors would still need to tailor there protocols for some patients even with a delayed schedule.

Could you please show me the studies proving this drastic increase in vaccine-preventable diseases truly attributable to just delaying the schedule. Have you seen spikes in disease from the delay, or is it from those not vaccinating at all? It doesnt matter if you dont have proof YET that delaying doesnt reduce the risk of adverse reactions. What matters is trying to reduce the risk period. If there arent increases in all the diseases with a delayed schedule, then why cant some or all be delayed? Why fight such a simple concept. Almost every outbreak on record has been caused by completely ‘unvaccinated pockets’ of the population… NOT from those who delay a little. Actually, the population in general would be more protected if all would choose to get vaccinated on a delayed schedule rather than no vaccines at all.

There is no distinction between those individuals who have not been vaccinated and never intend to be and those who are not vaccinated but will be done so later. They are both unvaccinated. Until they are vaccinated, they are equally at risk of catching and spreading the disease. Thus, those who delay vaccination are, by definition, increasing the size of the unvaccinated population.

Now, Uncle Bob knows this full well, and does not deny it. He admits there is an increased risk, but just claims that the effect is not big enough to worry about, and that it is worth the risk to use the alternate “safer” schedule.

And here’s the fail. While we know that delaying vaccine, by definition, increases the risk (by some amount, admittedly it could be small), we have absolutely no indication that there is any benefit of any sort at all, small or not. In fact, as far as Uncle Bob Sears knows, the alternate schedule may actually be MORE risky than the tested schedule of the CDC. The only reason to do it is to make parents feel better. However, it is only doing that by feeding into their fears, instead of trying to help them.

I’ve said this before about fighting anti-vax sentiment. There is a difference between saying,

1) “Well, we can use an alternate schedule if you insist, however, I should tell you that there is no reason to think that it will be any safer for your child, and it will leave your child exposed to infectious disease that you don’t want”

and

2) “I understand your concerns about vaccine safety and therefore recommend this alternate approach, which could be safer.”

How did you manage that? My kids got 4 shots containing 6 diseases at their 2 mos visits and that was over 10 yrs ago. The issue isnt really about the injections-they hurt, they got a toy, they didnt care-the issue is obviously what is in it. I never thought what ‘poisons’ were in the shot, I used to think how can that immature immune system effectively mount the needed immunity to that many diseases at one time. I have not seen a study showing me that either. I wasnt thinking unsafe but rather unprotected. Is my child truly protected when he only mounts a substandard immune response to 6 different diseases. Or, maybe only mounts a reponse to 2 of the diseases and none at all to the others. I would like to see titers to each disease after receiving 6 or 7 at one time.

No, the population of unvaccinated children would not be as large if they were at least getting vaccinated on a delayed schedule. More people would choose to vaccinate if they thought(or later proved) it was safer. It would be much better to have only some under 2 not fully vaccinated yet, rather than alot under 14 not vaccinated yet. And, as you say, the risk to those not fully vaccinated would be even less if almost everyone else was vaccinated, true? I would be looking for any possible way to get more vaccinated.

“By the time he is 18 months-old, he will be completely on schedule. I do this for my son and I do this for my patients. To do otherwise is to practice poor medicine”.

With all those vaccines being given to your young one… He will be in my prayers. I pray that he isn’t injured by all those vaccines at such a young age. While we seem to disagree completely on vaccines… I do not wish for any child to be injured by vaccines.

Meson, an infant’s immune system deals with dozens or more antigens every day through the normal course of living. Mounting a proper immune response to six antigens from vaccinations doesn’t come close to taxing it.

There is no reason to expect greater safety from a delayed schedule and logical reasons to expect less because of increased risk of contracting disease.

“Immunogenicity in the Combination Vaccine Group was noninferior to that of the Separate and Staggered Vaccine Groups with respect to seroprotective rates for diphtheria, tetanus, and poliovirus and to geometric mean concentrations for pertussis. Seroprotective rates for HepB and Hib were not different between groups. Seropositivity for PCV-7 was high in all groups.”

“DTPa-HBV-IPV/Hib and PCV7 were highly immunogenic, well-tolerated and safe when coadministered at 2, 3 and 4 months of age with a booster dose at 12-15 months of age. These results support the coadministration of PVC7 with DTPa-HBV-IPV/Hib as part of the routine immunization schedule for infants and children.
“

There are other studies, as well. Just go to PubMed and search for whatever combination vaccine you want and the words “antibody titer”.

The response to the primary series of vaccines was below the mean. Seeing the above average response after the boosters makes me wonder if other immune responses in the body were also over triggered.

My children obviously did not have an adequate response. They seemed to like getting diseases they were already vaccinated for, and no, the symptoms were not diminshed. Pertussis and chicken pox(had booster) were the worst.

Forgive me if I misread the articles – I was in a bit of a hurry – but I seem to remember that the proportion of children who had antibody levels within the protective range were not statistically different. Given the wide range of titers seen after vaccination (two to three orders of magnitude), comparing the means may not be as important as comparing the numbers that were “seroprotective”.

As for the “above average” response after “boosters”, that would be a direct consequence of a “below average” response to the primary series. I can point you to a large numbers of papers showing that people who have lower antibody titers have more response to “booster” vaccination. This is not an indication that “other immune responses in the body were over triggered”, but simply the result of less pre-made circulating antibody to react with (and remove) the antigens from the “booster” vaccine.

Thus, one of the effects of “boosters” is to “even out” the antibody titers in the population and bring as many people as possible into the “seroprotective” range.

In reference to your own children, welcome to genetic diversity! Some people don’t mount adequate immune responses with some (or all) vaccines. That’s why it’s important for everybody (or as many as can) to be vaccinated – to protect those who either can’t be vaccinated or can’t mount an adequate response after vaccination.

BTW, you can easily get herpes zoster and pertussis titers – I’d suggest checking to see that your children are now immune, if you haven’t already. A failure to respond adequately to vaccinations can be a sign of an immune disorder.

Of course, if there were an easy way to know beforehand which of those in the population are going to not effectively respond to vaccines, then that would be awesome and could be accomodated. I realize that anti-vax woos throw out this idea of “testing” beforehand to check for those who might have serious reactions, but it’s definately not effective enough to make it cost feasible, and it’s not the same thing.

As Prometheus notes, it is because we don’t know who is going to be left susceptable that it is important that as many as can be vaccinated do so, and create a herd immunity to help protect everyone.

With all those vaccines being given to your young one… He will be in my prayers. I pray that he isn’t injured by all those vaccines at such a young age. While we seem to disagree completely on vaccines… I do not wish for any child to be injured by vaccines.

gaiainc – I will sacrifice a chicken and dance around a fire while chanting on behalf of your young one. I do not wish for your child to be injured by vaccines or by a belligerent elk. The latter is a much greater probability.

Titmouse, Pablo and others–Nice attempt to have it both ways. Vaccinate on the schedule or not. And, if not, why not? Hypocrisy burns. Docs do NOT vaccinate their own children on the recommended schedule.

Orac, I apologize for the Bill O comment. He has no integrity and bad intentions. I consider you to have both integrity and good intentions. We just disagree.

Let me put it this way. It was recently announced that the National Vaccine Information Center (NVIC), one of the oldest anti-vaccine groups, which was founded by Barbara Loe Fisher, is going to start funding research. (Fear not. I plan on blogging about it. I just got home now; it’s late, and I’m tired.) Would you accept it from me if in the future I were to automatically dismiss any research it funds just because of the funding source? Let’s say the NVIC funds a “vaxed versus unvaxed” study that claims to show that vaccinated children have a higher rate of autism? I take it from your excuse that it would be hunky dory if I were to dismiss such a study solely on the grounds of who funded it. Would you simply accept my rejection of such a study and then move on?

No! You wouldn’t! Nor should you.

Similarly I utterly reject your excuse for not addressing the meat of the studies that Prometheus listed. I’m going to be very, very blunt. Your dismissal of those studies as worthless because any of them was fully or in part funded by pharma is so intellectually lazy, it’s pathetic. Yes, pathetic. Harsh? Yes, but you deserve it. You get away with waving your magic hand and airily dismissing studies because you think they are fatally compromised without actually having clue one what they did or what the science shows.

In fact, your dismissal because of pharma funding, whether real or perceived, is nothing more than a convenient mental shorthand excuse for you to dismiss them without having to actually think about them or read them or–God forbid!–actually engage with evidence that challenges your belief that vaccines cause autism. I contrast myself to you in this. I routinely read journal articles that purport to challenge the scientific consensus that vaccines don’t cause autism. I take them seriously and treat them as such, even when I end up concluding that they are crap, for example the recent Hewitson/Wakefield monkey study.

Stop being so intellectually lazy, Dr. Jay. Address the substance of the studies or admit that you can’t. I’m tired of pussyfooting around. Time to put up or shut up.

Titmouse, Pablo and others–Nice attempt to have it both ways. Vaccinate on the schedule or not. And, if not, why not? Hypocrisy burns. Docs do NOT vaccinate their own children on the recommended schedule.

Occasionally clinical protocols and guidelines are not followed to the letter.

For example, at a facility I visit, kids are expected to be seen by the dentist annually. However, in the case of one large, non-verbal, aggressive autistic child, I preferred to wait for evidence of discomfort before setting up the dental exam, which must be done at a hospital under anesthesia. Anesthesia carries certain risks that don’t seem justified for an asymptomatic patient.

I have to wonder – do you dismiss/reject out of hand any and all research that meets or might meet this condition? I mean, I was under the impression that this was a general problem (the article you link to discusses several cases but doesn’t mention vaccine studies). Seems like if you adhered to this policy consistently, your work would grind to a halt. Or is it selective – just research on vaccines?

Yes, studies funded by the manufacturer of a vaccine or a medication can be dismissed out of hand. The researchers are paid by the drug companies and they get the conclusions they want a tremendous percentage of the time. You have certainly read that:

As I mentioned Jay, your post merely got caught by the spam filter due to the number of URLs therein. No conspiracy to silence you. And I see that Orac has actually released them anyway, which is nice of him to do so when he’d probably prefer to still be in bed.

Jay, we’re aware of that problem (and IIRC, Orac has discussed it previously), but you are making the false assumption that if a study is funded by a company, then it is automatically suspect. That is the bullshit and Orac has called you on it. It is a lazy way to dismiss large volumes of data with a single gesture.

You lamely try to discredit the strong science behind vaccination but refuse to provide any evidence for your alternative schedule. You’ve even admitted that you have no evidence for it at all. Come on, provide some evidence for your position for once. You’ve been asked dozens of times and every time you evade.

Regarding delays in vaccination schedules, there’s far greater danger in such delay these days when more and more very young children are in group day care situations.

The woman who cuts my hair was telling me yesterday that her 2-year-old is constantly getting various illnesses (he’s in a small generally well-run day care with 6-8 other young kids), and just got over an ear infection that led to a burst eardrum. She said her son was getting the seasonal flu vaccine, but was wondering whether she should get him vaccinated against swine flu as well. She’d heard the vaccine was untested, that there had been bad reactions to it, and that swine flu was relatively benign even if you did come down with it.

Without going into detail about my response, the summary is that I urged her to get her son vaccinated against swine flu as well as seasonal flu.

Really??? Well, if you value anecdotal evidence over actual studies, Dr. Gordon, then I call bullshit on this too. Every doc in my family (including one who was specifically a pediatrician) vaccinated their own children with everything, bang on schedule.

Wasn’t even that long ago.

Regarding your posts being held, anything with 2+ links gets held in spam until the moderator releases it. You’ve been on these forums *how* long and haven’t figured this out? So much for your observational skills. You’re awfully quick to claim there is some conspiracy against you, though.

But I’m going to echo Orac’s call, though, because his challenge is absolutely legitimate, and claiming you don’t have to answer it because you’re being picked on is a weak cop-out.

Deal with the science in the studies. If you think it’s rubbish, or it has been tainted, then demonstrate how.

Heh, just occurred to me — it’s the anti-science non-doctors in my family who have “concerns” about vaccines. All the medical professionals who I know and/or am related to don’t have a problem with it. Telling, that the people who know most about it are the ones with the fewest concerns about it, and the people who don’t tend to recognise science (in ANY field) when it walks up and bites them in the arse are the ones who are “scared.”

Prometheus–Every single study you cite was funded by the industry that makes the vaccines

Is that even true of all vaccine studies? I don’t think it is, and some examples come to mind. Of course, Dr. Jay might say they are funded by a government agency, which is all the same.

Every study is funded by someone. You could always dismiss a study based on this. You can always presume the funding source has an agenda.

Are we to believe that every single scientist in those studies is dishonest, that no whistle blower has come forward in the last 10 years just because? Are we to believe that none of those scientists has a relative who’s autistic?

With all those vaccines being given to your young one… He will be in my prayers. I pray that he isn’t injured by all those vaccines at such a young age. While we seem to disagree completely on vaccines… I do not wish for any child to be injured by vaccines.

gaiainc – I will sacrifice a chicken and dance around a fire while chanting on behalf of your young one. I do not wish for your child to be injured by vaccines or by a belligerent elk. The latter is a much greater probability.

Same old…., please do not pray for my son. I much prefer Militant Agnostic’s chicken sacrifice and fire-dancing.

As for not vaccinating on schedule, here is the CDC recommended schedule for children ages 0-6 years: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm#printable. Please point out to me how I am NOT vaccinating my son on schedule. Seriously. Where am I deviating or changing the schedule? Where is the delay? To say I am not vaccinating him (or my patients since I treat them the exact same way) on schedule is disingenuous and I’m calling BS.

The new oral vaccine is the rotavirus. I like the rotavirus vaccine. I’m not having to admit as many babies for dehydration secondary to nausea, vomiting, and diarrhea. GO VACCINES!

The hospital where I work is just starting to get H1N1 flu vaccine. This morning I registered to receive it as soon as it’s available, being in a recommended priority group (physician with patient contact).

This raises some interesting questions about Dr. Jay and his pediatric practice. Dr. Jay is also in this priority group, posing risk to (and at risk from) vulnerable young children and older children with chronic medical problems. Assuming Dr. Jay will be responsible enough to get himself vaccinated to avoid putting his patients (and their parents) in jeopardy, what does he then tell members of the other priority groups that he sees (i.e. people who live with/care for children younger than 6 months of age, children 6 months through 4 years of age, and children 5-18 who have a chronic medical condition)?

Does Dr. Jay say “Well, I got my priority immunization but I’m not recommending you and the kids get yours, because vaccines are DANGEROUS and UNTESTED and PROMOTED BY MEANIES.”

That might suggest a questionable double standard to parents (and in the case of the more intelligent ones, that Dr. Jay is a few ccs short of a full syringe).

And if Jay goes without his flu shots, what does that say about his commitment to his patients and their parents? Quite a conundrum for our intrepid antivax celebrity pediatrician.

I love it when cranks scream CONSPIRACY when their posts don’t appear immediately. Without fail, the posts show up and they never acknowledge the egg on their face. Usually, Jay is too savvy to make a rookie error like that, but here we have more evidence that he seems to be slipping. He’s triply wrong this time, since his comment was full of links and Orac is traveling.

Bravo, Jay. Really, keep posting. Your credibility and respectability is skyrocketing. Will you be commenting at Neurologica today? I know cranks don’t usually go over there because a lot of their ammo is taken away (their own anonymity, the author’s anonymity, the author being a meanie stinky poopiehead), but I thought a srs dctr like yourself might be interested.

Oh please! What is with all the name calling of Dr Gordon? I dont see any comments on the URL’s listed in 133, only personal attacks. There are several valid points that just get ignored? Some of you (namely rogue, militant, scott and bacon) come across as possibly educated, immature, lunatics instead of skeptics.

luna- professionals who practice ‘cookie cutter medicine’ are not geniuses.

Prometheus–Every single study you cite was funded by the industry that makes the vaccines

Imagine if lawyers could get away with being this pathetically lazy?

Judge: All right, now we’ll hear opening arguments from the prosecution.

Prosecutor: Your Honor, ladies and gentlemen of the jury, all the testimony you’re about to hear from the defense is automatically untrustworthy because it comes from the defense. Just remember that. We’re not even going to bother talking about the evidence, we’ll just tell you that whenever it benefits the defense it must be garbage.

Judge: Can’t you say anything relevant to the evidence?

Defense: Your Honor, it’s our turn to speak. Your Honor, ladies and gentlemen of the jury, all the testimony you’re about to hear from the prosecution is automatically untrustworthy because it comes from the prosecution. Just remember that. We’re not even going to bother talking about the evidence, we’ll just tell you that whenever it benefits the prosecution it must be garbage.

Judge: This is going to be a long, long trial.

I suppose we might start calling Jay Gordon a Parsley, Sage, Rosemary and Thyme scientist (PSRTS, for short.) In that song, the singer implicitly rejects his former lover by telling her she’ll be his true love when she fulfills some impossible demand, such as an acre of land between the seawater and the shore. Jay Gordon says he’ll accept convincing evidence, but only if it doesn’t come from anyone who would be convinced by evidence and act accordingly.

I understand that may seem mean and dismissive to someone who appears respectable and reasonable, but the short answer is, regulars here are very familiar with Jay Gordon, and, basically, have no respect for him. We’ve tried to discuss reasonably with him, but he has said some blatently idiotic things over the last few months that no one can take him seriously. Among others, you can always count on Jay to resort to a conspiracy of some sort (now he is whining that his posts are getting held back for moderation, as if it is a personal attack – of course, the forum has filters that hold certain features for moderation automatically).

Then of course there is Jay’s famous “my experience means more than scientific studies” and the even better, “Who ever said that objective studies are more scientific than my experience? I assert my way of doing science is better.”

So we have given up trying to talk to him. I consider him mostly a punching bag. However, I seem to have hurt his feelings, and he has threatened to ban me from his website, if he ever has one.

I’ve mentioned this reference before, that I always think of with Jay

Guy in charge of phenoltryptochalene (it’s a Russian inwention): “Captain, I get the impression that you aren’t taking this matter very seriously!”
Kirk: “On the contrary, sir, I take this matter very seriously. It is YOU I don’t take seriously.”

What?! Move to strike as nonresponsive. (Not to mention that it doesn’t exactly help your case here.)

Now would you care to answer my question: “do you dismiss/reject out of hand any and all research that meets or might meet this condition?”

Otherwise – if you’re singling out vaccine studies (which are not mentioned once in either of the articles you’ve cited) – it would appear that you are being not intellectually lazy but intellectually dishonest.

You appear to believe that on Earth someplace are researchers driven to spend years of their lives studying treatments without any personal interest in the outcome.

Most new compounds the large pharmaceutical companies develop and research don’t pan out, either due to lack of efficacy or safety concerns. How can you explain this?

I think I understand your inability to summarize the current scientific consensus regarding vaccines. You’ve dismissed it all as contaminated by corporate sponsorship and so have no familiarity with it.

What?! Move to strike as nonresponsive. (Not to mention that it doesn’t exactly help your case here.)

Now would you care to answer my question: “do you dismiss/reject out of hand any and all research that meets or might meet this condition?”

Otherwise – if you’re singling out vaccine studies (which are not mentioned once in either of the articles you’ve cited) – it would appear that you are being not intellectually lazy but intellectually dishonest.

If you paid more attention, you’d take me and my ideas seriously. I expect nothing of you and you don’t disappoint.

Yes, the prosecution does ask the jury to doubt or dismiss the defense’s argument.

Read the links posted and you’ll see that doctors just a little more prominent and respected than I agree that the pharmaceutical industry influences research far more often than the public knows. You, however, should know better. Defending these studies is intellectual dishonesty.

147 scott, ‘millions’? are you really claiming that will happen from a delayed vaccine schedule? There really arent any facts to prove that. I looked after post 107 questioned, and I found nothing. If you want to attack a true idiot, then go back to John who inspired this thread.

@Pablo “While we know that delaying vaccine, by definition, increases the risk (by some amount, admittedly it could be small), we”

If you are going to project, then I would have to agree that getting more of the population vaccinated by accepting a delayed schedule would increase our herd immunity and ultimately decrease the risk even more. Delaying ‘might’ help with reactions. If that schedule gets more people to vaccinate, the better off all children will be.

scott, You should put that energy into my research. Millions are already dying and many millions more will die with our lack of food sources and fresh clean water. Dont fool yourself into thinking this does not affect the US too.

I wonder why Dr. Gordon comes here. Though he says he learns a lot, I haven’t seen a change in his views. One exception might be his removal of an HIV-denialism article from his web site when some attention was drawn to it here. I suspect he simply realized how impolitic HIV denialism is among many in the entertainment industry.

My guess is he’s working on a book. Coming here may be a way to measure the heat he might feel once his book is out. It’s probably reassuring when he encounters familiar criticism, which hasn’t impacted his success to date.

Is that even true of all vaccine studies? I don’t think it is, and some examples come to mind. Of course, Dr. Jay might say they are funded by a government agency, which is all the same.

Every study is funded by someone. You could always dismiss a study based on this. You can always presume the funding source has an agenda.

I don’t believe that drug development should be for profit in the first place, and am quite attuned to systemic problems, but Dr. Jay appears to be highly selective in his extreme skepticism, especially since vaccines (much less the vaccines schedule – ?) haven’t been noted from what I ‘ve seen as a problem area.

legatee bhutan, you’re giving Jay too much credit. Sometimes he outright rejects vaccines, as he has with the H1N1 flu vaccine. Also, his plan only isn’t *that* bad because most people ignore it; that is to say, he and his patients are mooching off herd immunity (the responsible behavior of others). If everyone followed his unsubstantiated gut feelings about vaccines, mostly-eradicated diseases might return in force. A minor point, but one that gives Scott’s claim more credibility.

Also, are you seriously suggesting that delaying vaccination might be good because it might improve vaccine acceptance? Taking a page from religious apologetics, are we? “Sure, my nonsense caused a problem. But, don’t blame me or reject my nonsense, because here’s some more nonsense that might fix the problem!”

147 scott, ‘millions’? are you really claiming that will happen from a delayed vaccine schedule? There really arent any facts to prove that. I looked after post 107 questioned, and I found nothing. If you want to attack a true idiot, then go back to John who inspired this thread.

Who said anything about delayed (which, I agree, wouldn’t be as bad)? Jay makes it quite clear that he wants all vaccines to be stopped entirely. And yes, that most certainly would kill millions, in the US alone.

scott, You should put that energy into my research. Millions are already dying and many millions more will die with our lack of food sources and fresh clean water. Dont fool yourself into thinking this does not affect the US too.

I’ll also note that in most of the cases discussed in those articles, the relationships were, of course, concealed. So, by Dr. Jay’s standards, you would have to assume that every scientific study is bogus and reject out of hand all research that’s been carried out for decades, even in areas where there is a huge body of research produced by numerous people in different countries over years or decades. Is that what you’re proposing, Dr. Jay? Do you prescribe on the basis of any research? How do you justify that?

@Pablo “While we know that delaying vaccine, by definition, increases the risk (by some amount, admittedly it could be small), we”

If you are going to project

Who’s projecting? I’m not projecting anything. It is a fact: those who are not vaccinated because they are being “delayed” are no different from those who are not vaccinated and will not be. It is not until they get vaccinated that there is a difference. And the non-vaccinated are at an increased risk for catching and/or spreading disease. This is not projecting, it is just a statement of reality.

Now, as to the claim that delayed vaccinations are better than no vaccinations ever, that is true, but is a false dichotomy. Delayed vaccinations are better than no vaccinations, but scheduled vaccinations are better than delayed vaccinations. So if the question is what is better, then push for what’s best. Especially since there is absolutely no indication that it is any more costly or risky.

Jay Gordon doesn’t do that. He doesn’t promote what’s best, and has no problems appeasing the anti-vaxxers.

Again, it comes down to a real, undeniable albeit small increase in risk due to lack of timely vaccination, vs no known benefits. It fails any cost-benefit analysis.

Yes, the prosecution does ask the jury to doubt or dismiss the defense’s argument.

The way you do it? By just saying “it’s automatically garbage if it comes from the defense,” the way you do? Sorry, no, real lawyers don’t work that way, and neither do real scientists – meaning that you aren’t a real scientist, however much you pretend to be.

Look at the Verstraeten study (obviously not the actual words spoken by the relevant parties, and I mean the real story, not the stupid conspiracy theory you hear from tools like RFK Jr.):

Verstraeten: I went through all the data we had in this database, and I tried to match up the kids that were reported on so that we could compare kids who were vaccinated, with kids who were as like them as possible, except not vaccinated. When you arrange a comparison like that, it sure looks like kids who were vaccinated have more neurological problems than kids who were just like them but unvaccinated.

Other Scientist: Well, I’m not so sure that you did what you think you did with that data. You said that you thought you matched up the children so that they were as like each other as possible, with the exception of whether or not they were vaccinated. Right?

Verstraeten: Right.

Other Scientist: But I haven’t heard you talk about what might be a really significant difference between your groups. Were the kids you’re comparing alike in how often they got taken to the doctor’s? Maybe the same mother who won’t take Johnny to the doctor for his booster shots also won’t take him to the doctor just because he slurs his words and twitches.

Verstraeten: Ohhhhh. I see what you mean. I tried to make it so there was only one big difference between the groups: whether they’d been vaccinated or not. But there might be two big differences: vaccination, and whether the parents take them for medical attention in the appropriate circumstances. How can we ever know which of those two differences accounts for the difference in the reported rate of neurological problems between the groups?

Other scientist: I have an idea about that. If one group is getting diagnosed more frequently with neurological problems just because they’re going more often to the doctor, then they should also be getting diagnosed more often with physical problems that couldn’t be the result of vaccination, like clubfeet.

Verstraeten: Oh, I see. Let’s call the rate at which vaccinated kids are diagnosed with more neurological problems than unvaccinated kids the “neuro rate”, and the rate at which vaccinated kids are diagnosed with more physical problems than unvaccinated kids (that can’t be due to vaccination) the “physical rate”. If we’ve now accounted for all our factors, the physical rate will have to be what’s due just to the fact that some parents are more willing to seek medical attention for their children, what we might call the “parental willingness factor”. But the neuro rate would be due to the parental willingness factor, plus any difference produced by vaccination.

Other scientist: Right. If the neuro rate is higher than the physical rate, then the evidence would still be consistent with the hypothesis that vaccination is causing neurological problems. But if the neuro rate and the physical rate are the same, it torpedoes the hypothesis: the neuro rate is the physical rate plus the difference due to vaccination, but there’s no difference due to vaccination!

Verstraeten: Right! Okay, let me go recalculate these numbers and see what we get. (Later) Hunh, what do you know? Once we account for the difference caused by the parental willingness factor, there isn’t any difference left to be explained by vaccination. I guess that’s the way science goes.

Now, let’s contrast that with the garbage we get from Gordon:

“Every single study you cite was funded by the industry that makes the vaccines and the researchers are also in their thrall.”

How utterly lazy! No “I think you may have failed to consider X as a confounding factor” or “did you properly control for Y?” No, Gordon just thinks that all he has to do is fling mud and he’s levelled the playing field. What garbage!

Jennifer, if you’re not capable of more civil discourse, please stop directing your posts at me.

I spend my day with three-year-olds who have better social skills than you do. You’re embarrassing yourself.

As someone has mentioned, stop name-calling. I will, too.

You keep using words like “lame” because you disagree with me. Stop that, please and seek more logical and useful answers.

When you all talk about pediatrics, it’s as if I tried to write a post about plumbing or neurosurgery because I’d read three articles on the internet. Yes, my experience in this specialty trumps your reading those three articles.

And, I have talked to more pediatricians than any of you and I will repeat for the third time: We do not vaccinate our children on the same schedule we recommend for our patients. The risk—while not huge—need not be taken when there are more sensible ways to give shots.

Of course I prescribe on the basis of research. I just am a little more critical of conflict of interest and therefore interpret the studies differently than you might. Speaking with less haste and hyperbole than above, I have to correct the my statement about dismissing these studies. Research should not be funded by those who have a financial interest in the outcome. I assume that’s not a controversial concept.

Why do I come here? Because I enjoy the better parts of the conversation and have thick enough skin and enough confidence in my skills and knowledge to handle my numerous detractors. I do not feel good about having resorted to unpleasantness recently and I will work on that problem.

I think Pablo didn’t make his analogy clear enough. I think it should have the prosecutor saying “The defense arguments are garbage because the defense lawyer is being paid by the defendant.” and then sitting down.

The risk—while not huge—need not be taken when there are more sensible ways to give shots.

What risks are associated with the current vaccine schedule? Please provide links to data, not anecdotes. Further, what evidence supports your altered schedule as safer than the current one recommended by CDC and AAP? Please provide citations to published studies.

I think Pablo didn’t make his analogy clear enough. I think it should have the prosecutor saying “The defense arguments are garbage because the defense lawyer is being paid by the defendant.” and then sitting down.

As much as I would like, I can’t take credit for that. That was Anteaus Feldspar.

Since I don’t bother reading the troll, I’m trying to figure out, did someone actually have trouble understanding the original analogy? You would have had to be pretty darn dense…

When you all talk about pediatrics, it’s as if I tried to write a post about plumbing or neurosurgery because I’d read three articles on the internet. Yes, my experience in this specialty trumps your reading those three articles.

Oh come now, don’t be so modest. Your experience clearly trumps the collective experience and judgement of the AAP, too! Or at least, you think it does.

Jay, I cannot find anywhere in this thread where I have called you ‘lame’ or any other derogatory name. And as far as raising the level of discourse, your naive assessment of my debating abilities aside, you’re simply not worth the effort. One of us should definitely be embarrassed by the comments we’ve left on this blog, but it isn’t me.

though in his case the sham politeness masks the Dunning-Kruger effect rather than evil.

‘Also, are you seriously suggesting that delaying vaccination might be good because it might improve vaccine acceptance? Taking ‘

for some, yes! The unvaccinated group is never going to vaccinate without some kind of change. I just want as many vaccinated as possible. If you can at least bring them into the delayed group you are increasing the herd immunity.

“Jay makes it quite clear that he wants all vaccines to be stopped entirely. ” “utterly irrelevant”

sorry, I never saw a declaration to completely stop all the vaccines.
My relevance is that I dont just imagine there could be a million deaths. There is only a concern over pathogens if you are still alive. \/

Oh, and just to clarify, before Dr. Gordon claims there is no evidence for the CDC-recommended schedule, in a previous thread, I posted a link that CDC revises the schedule every year, based on the latest scientific evidence, publishing the schedule each January.

Research should not be funded by those who have a financial interest in the outcome. I assume that’s not a controversial concept.

facepalm

A naive idea with no basis in the real world. Who do you propose pay for all of this research? The government? If so, where do they get all of the money?

There is nothing wrong with stakeholders wanting to know if their product works, how well it works and if it has side effects. Yes, you must be aware of conflicts of interest and they should be clearly stated. But the comparatively small number of cases where companies have improperly influenced papers should not be used in an attempt to discredit all reports funded by grants from commercial interests.

If we impose your standard, applied research will, for the most part, be shut down. Not only in medicine, but in many, many other fields.

If we impose your standard, applied research will, for the most part, be shut down. Not only in medicine, but in many, many other fields.

You say this as if it is a bad thing. However, it is great for Jay, because then he can say whatever he wants and no one can expose him for being clueless. He can pretend to be an authority, and no one will challenge him.

Dr. Jay: As noted in my previous post, I (and I believe others) would be very interested in hearing whether you have gotten or will be getting flu shots (HIN1 and the usual seasonal flu vaccine), in accordance with expert recommendations for health care providers with close patient contact – and if you will be protecting yourself, are you also recommending against such vaccine protection for parents and patients who similarly fall into priority groups for immunization? If so, how do you justify such a stance?

Dr. Jay says: “Of course I prescribe on the basis of research. I just am a little more critical of conflict of interest and therefore interpret the studies differently than you might. Speaking with less haste and hyperbole than above, I have to correct the my statement about dismissing these studies. Research should not be funded by those who have a financial interest in the outcome. I assume that’s not a controversial concept.”

Do tell. Apart from your dismissal of vaccine recommendations, what other diagnostic and therapeutic measures widely accepted by your colleagues do you also refuse to utilize, on the basis that they were developed by people who conceivably had a financial interest in the outcome of their research? Surely you realize that drugs, tests and devices common to your field were made possible by those receiving grants and support from government and industry, to an equal or greater extent than vaccines. If you truly believe that such research is unworthy of acceptance, then you must be practicing some form of folk medicine.

Really, what other tests or interventions do you deny your patients on this basis, apart from vaccines?

Dr. Jay: “And, I have talked to more pediatricians than any of you and I will repeat for the third time: We do not vaccinate our children on the same schedule we recommend for our patients.”

What is your basis for this claim, apart from unsubstantiated anecdote?

Finally, the allegation that Orac is trying to silence poor Dr. Jay by holding up his posts is ludicrous, on the very sort of financial basis that obsesses Dr. Jay. Every time Dr. Jay posts his silliness here, comments (and undoubtedly page views) jump. Just by seeing the leap in comments from 127 to 170 or so before I posted this, I knew that Dr. Jay had been by to drop one of his turds of ineptitude. Seeing that whatever pittance Orac makes from ScienceBlogs depends on traffic to this blog, it’s obvious that Dr. Jay’s ramblings are adding pennies to Orac’s piggy bank and thus he wouldn’t want to shut Dr. Jay up, however painful it is to see a fellow physician debasing himself with antivax idiocy, appeals to conspiracy theory and ignorance of the scientific method.

And, I have talked to more pediatricians than any of you and I will repeat for the third time: We do not vaccinate our children on the same schedule we recommend for our patients.

Wow. I am floored and absolutely appalled by these two sentences. The first for the arrogance to assume that he has spoken to more pediatricians that any one else commenting on this blog (wrong) and the second for the callousness in not treating his patients like he treats his children (callousness is not the word I really want, but I’m too stunned to come up with a better word). This re-affirms for me that I would never take my child to see him. Period. Even if he was the last doctor on earth.

Oh and the “we” in the sentence above does not represent any of the pediatricians that I know and talk to.

The onus rests upon the party selling a product or an idea to prove the merit of that product or idea. This is the only rational system possible.

Attempts to shift the onus of proof from the seller to the buyer only serves the seller’s interests. Very bad idea.

Of course the buyer is burdened with a duty for some due diligance in reviewing the seller’s argument before accepting it. This duty is expensive enough.

When we find corporations cheating, we revise the rules to stop that. For example, by requiring companies to register all trials before they begin, we can eliminate the “file drawer effect” –i.e., the unpublished negative studies that don’t become a part of a systematic review.

Large medical studies involve so many players – patients, nurses, labs, doctors, families – that it’s difficult imagining how to rig the game so that a study will produce only the results the researchers want.

Large medical studies involve so many players – patients, nurses, labs, doctors, families – that it’s difficult imagining how to rig the game so that a study will produce only the results the researchers want.

If the NWO/reptoids can manage a conspiracy as big as 9/11 while keeping all the biologists and paleontologists on board with maintaining the fiction of evolution and simultaneously hide the fact that Obama was not born on this planet, rigging a few large medical studies should be easy for them.

When you all talk about pediatrics, it’s as if I tried to write a post about plumbing or neurosurgery because I’d read three articles on the internet. Yes, my experience in this specialty trumps your reading those three articles.

Dr Jay Sez “When you all talk about pediatrics, it’s as if I tried to write a post about plumbing or neurosurgery because I’d read three articles on the internet. Yes, my experience in this specialty trumps your reading those three articles.”

Jay I just checked PubMed and Scopus. I’ve written more articles on pediatric public health than you (which in your case appears to equal zero). Yes, my (demonstrable) experience in this specialty trumps your reading a bunch of antivax websites.

Sorry. Correction to the above. Should read “…PediatricS AND/OR public health…”

Of course the qualifications of the people having a scientific argument are irrelevant to the correctness of that argument anyway. Which is why most people on the internet don’t put a series of qualifications after their name in order to bolster a solid argument. Argue the data not your self-perceived special status. Which, frankly, isn’t any better than anybody else here.

“Yes, studies funded by the manufacturer of a vaccine or a medication can be dismissed out of hand.”

Wow.

That’s an awfully big chunk of ignorance to swallow at one time. Give me a second.

Wow.

I am reminded of a quote – widely, if mistakenly, attributed to Herbert Spencer:

“There is a principle which is a bar against all information, which is proof against all arguments, and which cannot fail to keep a man in everlasting ignorance—that principle is contempt prior to investigation.”

Now, don’t get wrong; I am all for contempt after adequate investigation. And I don’t think you have to immerse yourself completely in the woo and nonsense in order to say that it is lacking in merit.

But to say that – a priori – any research funded by a “manufacturer of a vaccine or medication” can be “dismissed out of hand” is arrogance (and ignorance) of the first degree.

I can only imagine how freeing it must be to have an intellectual philosophy that allows you to airily dismiss whatever you don’t agree with. Unfortunately, I’m stuck with a conscience that won’t allow me to do that, so I have to slog through the studies, examining their methods and the way they analysed their data.

“Dr. Jay”, on the other hand, simply dismisses them.

But, after all, he is special – he is a doctor, a by-God pediatrician (and don’t you forget it!), so his Word is Law and his Experience is Truth.

I wish I could be so confident in my innate ability to distinguish fact from fiction at a glance (or, in fact, without a glance).

The good part about this…. eccentric comment from “Dr. Jay” is that we now have a “piece of the puzzle (why do I feel that I’m on a ‘blog version of the game show, “Concentration”?). We now know that part of “Dr. Jay’s” definition of “adequate safety and efficacy studies” is:

[1] Not done by the companies that are required by the FDA to perform such studies in order to obtain FDA approval.

Maybe, with enough pushing and coaxing, “Dr. Jay” will give us another piece of the puzzle. I have a few guesses what they might be:

[2] Not done by any governmental agency that is charged with the responsibility to research public health or drug safety (e.g. the CDC or the FDA).

[3] Not done by any professional organization that has issued vaccination recommendations in the past.

[4] Must show the results that “Dr. Jay’s” clinical experience tells him are true.

Ildi—Naah. Pediatricians are just basically nice people. We have to be: We work with kids all day and we sure didn’t go into the lowest paid specialty in medicine for the wealth and glory.

Todd—Do me a favor: Stop asking that question, use PubMed and you can find and publish the links for us. They are there.

Scott—These are repetitive criticisms of me. I have never said that my experience trumps any of those things. I merely think that my experience is valuable in the discussion. Research is important but putting experience on the bottom rung of the hierarchy of science is just something that you or Orac or someone else made up.

Jennifer—Oh, well . . .

“Jay makes it quite clear that he wants all vaccines to be stopped entirely. ” “utterly irrelevant”
sorry, I never saw a declaration to completely stop all the vaccines.

You never saw it because it never happened. As I’ve said, I give vaccines every day.

Bug and Pablo Bug—There are many other ways of funding research and you know that. It’s done all the time.

Bacon—How do I count the ways?

I wash my hands. Pediatricians are exposed to countless organisms every day, all year. This new H1N1 is just another virus. No, I will not get the flu shot. I will support giving it to higher risk children and parents with underlying medical issues indicating it’s use.

I use lots of medicine and interventions tested by people with a financial interest but I think I (or you) would be a fool if we accepted this research literature uncritically. And that is what I just said. Reread please.

More pediatricians than you? Yes, anecdotal evidence only. Vaccine schedules? The same. No proof, just anecdote. Take it or leave it. You may leave it.

Gaia Incorporated—I do vaccinate my patients on the same schedule I would use for my child or loved ones’ children. You misread me. You have spent thrity years or more speaking with pediatricians? Training at three excellent hospitals and on staff at many hospitals in good standing for three decades? OK, then you may have spoken to as many as I have.

Titmouse—They do rig the game. Look it up.

David Kirby is an expert journalist. He and I disagree about certain things.

Antipodean—Thank you. I look forward to your contributions to this discussion. Do you mind not remaining anonymous?

To Antipodean, Bacon and some others, my email address is easily available. I would enjoy private email exchanges if you’d like.

Ildi—Naah. Pediatricians are just basically nice people. We have to be: We work with kids all day and we sure didn’t go into the lowest paid specialty in medicine for the wealth and glory.

Todd—Do me a favor: Stop asking that question, use PubMed and you can find and publish the links for us. They are there.

Scott—These are repetitive criticisms of me. I have never said that my experience trumps any of those things. I merely think that my experience is valuable in the discussion. Research is important but putting experience on the bottom rung of the hierarchy of science is just something that you or Orac or someone else made up.

Jennifer—Oh, well . . .

“Jay makes it quite clear that he wants all vaccines to be stopped entirely. ” “utterly irrelevant”
sorry, I never saw a declaration to completely stop all the vaccines.

You never saw it because it never happened. As I’ve said, I give vaccines every day.

Bug and Pablo Bug—There are many other ways of funding research and you know that. It’s done all the time.

Bacon—How do I count the ways?

I wash my hands. Pediatricians are exposed to countless organisms every day, all year. This new H1N1 is just another virus. No, I will not get the flu shot. I will support giving it to higher risk children and parents with underlying medical issues indicating it’s use.

I use lots of medicine and interventions tested by people with a financial interest but I think I (or you) would be a fool if we accepted this research literature uncritically. And that is what I just said. Reread please.

More pediatricians than you? Yes, anecdotal evidence only. Vaccine schedules? The same. No proof, just anecdote. Take it or leave it. You may leave it.

Gaia Incorporated—I do vaccinate my patients on the same schedule I would use for my child or loved ones’ children. You misread me. You have spent thrity years or more speaking with pediatricians? Training at three excellent hospitals and on staff at many hospitals in good standing for three decades? OK, then you may have spoken to as many as I have.

Titmouse—They do rig the game. Look it up.

David Kirby is an expert journalist. He and I disagree about certain things.

Antipodean—Thank you. I look forward to your contributions to this discussion. Do you mind not remaining anonymous?

To Antipodean, Bacon and some others, my email address is easily available. I would enjoy private email exchanges if you’d like.

@Scott
Homer nods, and I apologise. But you should have blockquoted and cited.

@bhutan
No one says clean water isn’t integral to improving public health. But that remaining disease burden which cannot be resolved by sanitation alone can be remedied by vaccination. We dog on Dr. Gordon because he’s disingenous in his claims that he isn’t anti-vax (at best), and because he and people who think like him are ushering in new wave of otherwise-preventable disease. Lives can and will eventually be lost. Yet he won’t shut up and do something positive about it. Therefore he earns our ire. With that said, you sound like a concern troll. I’m just a curmudgeon, but I’m not going to let babies die of measles on my watch.

Of course I don’t claim that fraud never happens. I’m arguing that there are ways to make fraud unlikely.

It’s naive to imagine that removal of corporate sponsorship will usher in a new era of honest research. Humans care about many things, money being only one of them. Ego, control, loyalty, revenge, belief –there are many reasons why a person might prefer the truth to be one way rather than another.

I worry more about the conflicts of interest I can’t see than those that I can see.

Research is important but putting experience on the bottom rung of the hierarchy of science is just something that you or Orac or someone else made up.

There’s a mechanism for translating first person data into third person data: the case report.

It takes time to write up case reports and I don’t expect doctors to bother usually. However, when one has important observations that might alter the way we all should be caring for patients, I believe it’s our duty to write those cases up so that our peers can review and comment.

Research is important but putting experience on the bottom rung of the hierarchy of science is just something that you or Orac or someone else made up.

Bloody hellfire. I’d hate to fly on an aeroplane designed by a Jay-alike engineer.

Snerd, would you like to fly on a plane designed by an experienced aerospace engineer who integrated life’s experiences with research or one designed by an inexperienced engineer who relied exclusively on what he’d read?

Snerd, would you like to fly on a plane designed by an experienced aerospace engineer who integrated life’s experiences with research or one designed by an inexperienced engineer who relied exclusively on what he’d read?

Except that’s not parallel to the current situation. You don’t “integrate life’s experiences with research”, you claim that your own personal experiences are superior to research. A so-called “aerospace engineer” that operated the way you do would probably design exclusively blimps; when asked about more modern developments like airplanes, our “aerospace engineer” would reply that there is no real evidence that heavier-than-air flight can ever work. After all, all research purporting to demonstrate that airplanes fly is produced by Big Aerospace or by the researchers who are in their thrall, a clear conflict of interest, so obviously the only people who can be trusted on the subject of airplanes are those who have zilch to do with airplanes.

Research is important but putting experience on the bottom rung of the hierarchy of science is just something that you or Orac or someone else made up.

Is there research that suggests experience is a superior form of evidence compared to research? Wait, that wouldn’t matter – such studies would be trumped by Dr. Jay’s experience either way.

Here’s a question. On what basis do you discount the experiences of doctors who treated patients by means of bloodletting in the 19th century? What is the rationale? Is your experience with bloodletting contrary to theirs, Dr. Jay?

Yes, Jay, I’m aware that there is other funding, but I’m also have enough academic research experience to know those sources can’t come anywhere near providing the amount needed. I’m still waiting for a real answer on where to come up with all of the research money needed if you prohibit corporate funding.

Looking back at my publication record, I guess you’d automatically dismiss about 2/3 of my papers because I took that ebil corporate money.

I’ve met engineers who think that their experience trumps science and best practice, they’re the ones who make mistakes and get people killed. Dr Jay you are the medical equivalent of those engineers and it’s only a matter of time until something goes horribly wrong.

No, Bug, I would not dismiss your research but I would know that you would have trouble getting more funding if your conclusions didn’t match what your funding source wanted. That concept has been studied and published.

If you were not anonymous, I’d go read what you’ve written.

Prometheus, to answer your question: No, you’ve guessed wrong. You get two more tries.

Todd—Do me a favor: Stop asking that question, use PubMed and you can find and publish the links for us. They are there.

You’re the one claiming that your altered schedule is as safe as, if not safer than, the schedule recommended by the CDC and AAP. The onus is on you to provide the evidence to support your claim, not on me or anyone else here. If the studies are on PubMed, then you should have absolutely no problem providing the links. I know my question is an uncomfortable one for you, because you can’t answer it, as evidenced by your request that I stop asking. But, I’ll keep asking until you answer with evidence or until you admit that your schedule is not only not supported by evidence, but that it could, in fact, be more dangerous.

So, upon what scientific evidence do you base your claim that your altered schedule is at least as safe as the schedule recommended by the CDC and AAP?

Please, do you always go with the all or nothing gambit? You must, because you keep missing the point.

We know that funding sources can sometimes influence the reported results. But, it doesn’t always influence the results. That’s the part you seem unable to understand and why your suggestion was so naive.

But then, when you say that I couldn’t get funding “if your conclusions didn’t match what your funding source wanted,” you are admitting that there isn’t enough funding sources out there to cover everything.

Dr. Gordon writes: This new H1N1 is just another virus. No, I will not get the flu shot. I will support giving it to higher risk children and parents with underlying medical issues indicating it’s [sic] use.

An analysis of the sickest swine flu patients in Australia, Canada, Mexico, and New Zealand suggests that relatively healthy adolescents and young adults are among the most likely to get very sick after an H1N1 infection, a pattern similar to that seen in the 1918 influenza pandemic.

Almost all critically ill patients in the studies were sick for only a few days before rapidly progressing to more severe symptoms and respiratory failure, which required treatment with a breathing machine, according to three studies published in the Journal of the American Medical Association.

The mortality rate ranged from 14.3 percent to 41.4 percent, depending on the country. The findings may help shine some light on what the 2009 H1N1 flu season may bring, and who may be hit the hardest by the swine flu during the next few months.

“These studies are telling us that young people are at risk for bad complications of H1N1 and under usual circumstances, [seasonal] flu does not cause acute respiratory failure in younger people,” says Dr. Neil Schachter, the medical director of the respiratory care department at Mount Sinai Medical Center, in New York City.

All the information I have seen indicates that Dr. Gordon is exactly wrong – H1N1 is not a virus about which only the classically vulnerable populations need worry.

Dr. Jay apparently lives in a world where grant providers only want positive results and expect full compliance from researchers. Never mind the fact that these providers want real data to know if their new product actually works. Or know how well it works in comparison to other means. They also want to know possible adverse effects. They want researchers to give them solid information so that the company can make multi-million dollar decisions.

Oh, and Dr. Jay, I have worked on projects that returned negative results to the granting corporation. That particular formulation didn’t work, so they discontinued it and moved on to testing different ones. Funny thing, it didn’t hurt our ability to get grants at all.

Don’t think that things are all rosy. Some companies do get upset at negative results. But, they also get reputations and fewer researchers will try to get funding from them. Funny how things like that work. 😉

Gah! Ashamed to be Australian at this moment. Unfortunately, as others have said, it’s all too common. My time in the ‘news’ section of one of Aus’s largest forums has taught me never to be surprised when it comes to people’s inability to rationally look at the evidence. The conspiracy theorists seem, for some reason, to automatically give greater credence to any site/post/opinion that challenges the establishment or implies a cover-up. Even people proclaiming (anonymously online) to have PhD in Toxicology. Have I seen you before, John?….

I’ve also published a clinical trial which was sponsored by a pharma company which showed the drug might actually have made the disease in question worse. A number of employees of that pharma company signed on as co-authors in the published paper.

How’s that for an anecdote to completely refute all published scientific studies to the contrary? It’s a perfect example of why clinical reasoning and anecdotes have been replaced by scientific study.

antipodean, Bug and others. You are correct: There probably are quite a few researchers and pharma employees and funding sources with enough integrity to continue funding research even when the results do not benefit their company or their product.

Never claimed they were; they’re just going by best available evidence. (Note, also, that vaccinating all the recommended shots on the recommended schedule also does allow for taking into account individual patient needs, such as the example upthread of keeping it to no more than 4 shots on a day, or rescheduling when the child isn’t well.) That doesn’t take genius. That’s just being sensible.

Please note, professionals who practice ‘unconventional’ or ‘unorthodox’ medicine based on personal bias and cognitive error and in defiance of best available evidence are not geniuses either.

Thanks to the poster who put up the link to Steve Novella’s article on Science Based Medicine – the one calling attention to Dr. Jay’s idiotic “open letter” on the H1N1 vaccine.

It’s noteworthy how Dr. Jay’s comments here differ from what he says in his “open letter”. In his comments here, Dr. Jay indicates he will follow at least part of the CDC’s recommendations for giving the vaccine to patients at risk:

“I will support giving it to higher risk children and parents with underlying medical issues indicating it’s use.”

But in his open letter, Dr. Jay makes clear that as far as he’s concerned, the number of his patients that will get vaccine protection is vanishingly small:

“I also won’t be giving the flu shot to the kids and parents in my practice unless there are extraordinary risk factors. I anticipate giving none at all this year.”

So, Dr. Jay is talking out of both sides of his mouth on this issue. Will he actually support giving the vaccine to those of his patients with underlying medical problems, like asthmatics and others on immune-suppressing drugs, or to parents caring for young children? His own remarks for maximal public consumption indicate not.

Dr. Novella does a nice job of shooting down Dr. Jay’s other misconceptions about H1N1, including the argument that it’s “just another virus”, and the suggestion that one is better off getting sick and achieving some fantasy lifetime immunity to influenza, as opposed to gaining immunity through vaccination.

As to our supposedly having “invented” criteria for the scientific method and downgrading “experience”, Dr. Jay is much like many alties I’ve had discussions with. They get bewildered and hurt when testimonials are rejected as insufficient evidence for one of their “cures”, and act as though I’ve invented evidence-based criteria merely to put down their pet beliefs. I expect more from someone like Dr. Jay.

Dr. Jay: “would you like to fly on a plane designed by an experienced aerospace engineer who integrated life’s experiences with research or one designed by an inexperienced engineer who relied exclusively on what he’d read?”

Let’s clean up this example and make it relevant to the issues at hand.

Let’s say my choice is between, on the one hand, flying on a plane designed by an experienced aerospace engineer using well-tested principles accepted by the vast majority of colleagues in his field — and on the other hand, boarding a plane built a draftsman without design experience, who rails against established principles of design, claims his own unpublished anecdotes are superior to research, and attacks the distinguished designer as untrustworthy because he makes money from developing superior aircraft.

On the “just another virus” front, Dr. Albietz just put up a post on SBM that addresses that, in a response to a Mercola article on Natural News. Worth reading, because it addresses some common misconceptions that have been popularize, and some which Dr. Gordon appears to believe.

Dr. Jay, please read Jennifer B. Philips’s post at 188. Please. Afterwards, please explain to me how I misread you because I don’t see it at all. Even on re-reading, I just don’t see how I misread you.

You do have the choice not to get the seasonal flu or H1N1 vaccine. Personally, I think that is irresponsible in terms of patient care. As health-care workers we see and are exposed to and are great vectors for disease. If I can do something that has minimal risk to me in order to minimize the risk of me passing on a bad disease to a patient, then I do it. Hand-washing is great, but it’s not enough. However, your mileage may vary.

Jay, thank you for you kind comment at #205. I hope you stick with it, unlike past admissions.

Of course, there is an obvious follow-up question: How do you determine which studies are “tainted” and ought to be rejected, and which do you accept? I suspect you cherrypick based on your own preconceived notions, but I’ll happily correct my statement if you demonstrate otherwise.

Speaking with less haste and hyperbole than above, I have to correct the my statement about dismissing these studies. Research should not be funded by those who have a financial interest in the outcome. I assume that’s not a controversial concept.

So who can we find who doesn’t have any financial interest in public health?

I’ve met engineers who think that their experience trumps science and best practice, they’re the ones who make mistakes and get people killed.

Met them? I’ve worked for them, and have spent a good bit of my professional life cleaning up after them. Fortunately these weren’t life-critical applications but they could certainly sink vast amounts of money into making a buggy product late and unprofitable because they always “just knew” that they were Sierra Hotel engineers who didn’t need to do any of that Bravo Sierra methodology.

Egos like Jay’s are a dime a dozen. If you want an example from my field, look up Intel’s “Digital Home” initiative, AKA “viiv.” Hundreds of millions down the tubes thanks to some egos who were too 1337 to have to do things the way that lesser mortals do.

I just wish Jay were working for my competitors instead of killing children.